Provider Demographics
NPI:1962760504
Name:KATHRYN L. ECKERT, MD PC
Entity type:Organization
Organization Name:KATHRYN L. ECKERT, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SADIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLBET
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:775-333-8000
Mailing Address - Street 1:75 PRINGLE WAY STE 909
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-8405
Mailing Address - Country:US
Mailing Address - Phone:775-333-8000
Mailing Address - Fax:
Practice Address - Street 1:75 PRINGLE WAY STE 909
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-8405
Practice Address - Country:US
Practice Address - Phone:775-333-8000
Practice Address - Fax:775-333-8015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7545174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1760514830OtherNPI
NV1710990924OtherNPI
NV1881754208OtherNPI
NV002016570Medicaid